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Torsion of the testis
B G Currie1, I B Kern, B E Hagan
1Prince of Wales Children's Hospital, Randwick, NSW.
The Medical Journal of Australia
|November 20, 1989
Summary
Testicular torsion requires prompt diagnosis and surgery. Urgent treatment within 24 hours significantly improves testicular survival rates, with 90% of testes being normal post-operation.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- Testicular torsion is a surgical emergency requiring timely intervention.
- Delayed treatment negatively impacts testicular viability and function.
Purpose of the Study:
- To reinforce the necessity of urgent diagnosis and treatment for testicular torsion.
- To evaluate the diagnostic utility of the contralateral horizontal testis sign.
Main Methods:
- Retrospective analysis of 131 patients with testicular torsion admitted between 1965 and 1987.
- Assessment of operative timing and outcomes, including testicular normality at follow-up.
- Evaluation of the contralateral horizontal testis sign in affected patients.
Main Results:
- Delaying surgery beyond 24 hours without intervention resulted in only 5.5% of testes being normal at follow-up.
- Operations performed within 24 hours of symptom onset led to 90% of testes being normal.
- The contralateral horizontal testis sign was consistently present, indicating bilaterality and a predisposition to torsion.
Conclusions:
- Urgent surgical intervention is critical for preserving testicular function in cases of torsion.
- The contralateral horizontal testis sign is a reliable indicator of torsion and its bilateral nature.
- Anatomical factors, such as high tunica vaginalis investment, increase torsion risk.